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Introduction: The challenging work environments mental health nurses (MHNs) encounter can negatively impact their mental health, psychological well‐being and physical health. While these impacts have been investigated in quantitative research, little is known about work‐related stress from the perspective of MHNs. Aim: To explore the stresses faced by nurses working in mental health settings and to gain an understanding of the underlying workplace context. Method: A descriptive qualitative study with data collected via semi‐structured individual telephone interviews conducted with n = 21 Western Australian MHNs. Data were analysed using reflexive thematic analysis. Results: A total of 85 codes were generated that led to the identification of 13 subthemes and 4 main themes: (1) mental health nursing context, (2) work environment stressors, (3) factors that alleviate stress and (4) the impact of workplace stress. Discussion: Many of the stressors MHNs were exposed to are modifiable, such as understaffing and poor skill mix. Modifiable stressors increased risk for MHNs, impeded patient care and exacerbated inherent stressors such as patient acuity and complexity. Implications for Practice: This study collected data that provide rich descriptions of the experiences of MHNs and identify modifiable work‐related stressors that could be alleviated through effective leadership and management. [ABSTRACT FROM AUTHOR]

Integration is a hallmark of mixed methods research and is constantly evolving. Joint displays have emerged as an effective method of integration at the analysis and interpretation level, facilitating visual comparison of quantitative and qualitative findings to present inferences greater than the quantitative and qualitative findings alone. Although literature reviews and concept analyses frequently precede mixed methods investigations, these are not commonly included in the integration process. To advance mixed methods research, we present a novel method of integrating data sources including rigorous literature reviews using joint display, that builds on the concept of creating a sum that is greater than quantitative and qualitative findings alone, with examples from two research studies. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impact of a co-designed intervention to reduce time spent on clinical documentation and increase time for direct patient care. Design: A pre- and post-test interventional study with multi-method evaluation, reported according to the Transparent Reporting of Evaluations with Nonrandomised Evaluations Designs guidelines. Methods: An intervention to decrease the burden of documentation was co-designed and implemented. Pre- and post-intervention data were collected via time and motion studies and the Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey. Documentation audits were conducted to assess intervention fidelity. Results: Twenty-six shifts were observed (13 pre-intervention, 13 post-intervention). Although the coronavirus pandemic contributed to decreases in staffing levels by 38% (from 118 to 73 staff), the number of task episodes completed increased post-intervention, across all shift patterns. Documentation took less time to complete postintervention when assessing time per episode. A mean increase of 201 episodes was observed on morning shifts, 78 on evening shifts and 309 on night shifts. There were small increases for time spent on direct patient care compared to pre-intervention but there was less time per episode. Results from the BurDoNsaM survey indicated that participants felt documentation took less time post-intervention. Documentation audits found completion improved as staff gained familiarity, but deteriorated when staffing levels were reduced. Conclusion: The intervention was able to reduce time spent completing documentation, increasing the time available for direct patient care. Implications for the profession and/or patient care: Completing clinical documentation is part of the daily work of nurses and midwives. Clinical documentation needs to accurately capture key information in a concise and streamlined manner to avoid unnecessary burdens and release time for direct patient care. Impact: • This study tested a co-designed intervention to address the burden of clinical documentation for nurses and midwives, • The intervention reduced time spent on clinical documentation and increased time for direct patient care, • This study could be replicated to reduce the burden of clinical documentation in other settings and benefit clinicians and patients by releasing more time for direct patient care. Reporting Method: The study is reported using the Transparent Reporting of Evaluations with Nonrandomised Evaluations Designs (TREND) guidelines. Patient or Public Contribution: The research project and intervention evaluated in this study were co-designed through a clinician-researcher collaboration. A research team that consisted of clinically based nurses and midwives and nurse scientists was formed to address the burden of clinical documentation. As the end-users of clinical documentation, the clinically based nurse and midwife co-investigators were involved in the design, conduct, interpretation of the data, and preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aim and objectives: To gain an understanding of palliative care need and service utilisation in adult inpatients. The objectives were to 1) Determine the size and characteristics of the population of adult inpatients who were appropriate for palliative care referral, 2) Establish what percentage of patients, who were appropriate for a palliative care referral, had been referred to and/or were receiving palliative care. Background: Internationally there is evidence of high levels of unmet palliative care need. Early access to palliative care is associated with improved outcomes including improved quality of life and reduced healthcare costs. Design: An observational point prevalence study was reported using the STROBE guidelines. Methods: Data were collected directly from inpatient medical records at a 578‐bed tertiary private‐not‐for‐profit hospital by three Registered Nurses on 3 June 2021. Palliative care need was assessed using the prognostic criteria for the 12 conditions outlined in the Gold Standards Framework. Results: A total of 270 inpatients met study inclusion criteria. At a hospital population level, 29% (n = 78) of adult inpatients could have benefitted from palliative care. Of the 78 patients assessed as meeting criteria for palliative care, 29% (n = 23) were currently receiving palliative care with a majority of patients 71% (n = 55) not receiving palliative care. Conclusions: This study prospectively collected data and included all 12 conditions outlined in the Gold Standards Framework and found a high level of palliative care need. There was evidence of a high level of unmet palliative care need across conditions and treating specialities. Relevance to clinical practice: Estimates of palliative care need can be used to improve access to palliative care and assess operational requirements, including the staffing levels required to meet the level of palliative care need for adult inpatients. [ABSTRACT FROM AUTHOR]

Objective: To determine if an ultrasound‐guided femoral nerve block (FNB) is superior to an ultrasound‐guided fascia iliaca compartment block (FICB) in providing pain relief to patients with a neck of femur or proximal femoral fracture. Methods: A double‐blind randomised controlled trial was conducted. All participants received two blocks, one active and one placebo. An active FICB was administered to 52 participants and 48 participants received an active FNB. Results: Analysis was completed on data collected from 100 participants. Most patients were elderly and the majority were female. Both FICB and FNB achieved clinically significant mean reductions in pain scores (2.62 for FICB and 2.3 for FNB). There was no significant difference in reduction in pain scores between the two cohorts, P = 0.408. Conclusions: Ultrasound‐guided FNB is not superior to ultrasound‐guided FICB, with both facilitating an equivalent analgesia effect in patients with a neck of femur or proximal femur fracture. [ABSTRACT FROM AUTHOR]